肺耐药蛋白在上皮性卵巢癌中的表达及临床意义

目的 :探讨肺耐药蛋白 (lungresistanceprotein ,LRP)在原发性上皮性卵巢癌(POEC)组织中的表达及其临床意义。方法 :采用免疫组化SP法检测POEC 6 4例、经化疗后二次手术癌组织 2 3例以及良性卵巢肿瘤 2 1例石蜡标本中LRP的表达 ,并分析 6 4例POEC患者的临床病理资料。结果 :6 4例POEC组织中LRP阳性表达 5 3例 ,阳性率82 .8% ;2 3例化疗后癌组织中LRP阳性表达 2 3例 ,阳性率 10 0 % ;2 1例良性卵巢上皮性肿瘤中LRP阳性表达 7例 ,阳性率 33.3%。POEC中LRP的阳性表达率与良性肿瘤中表达率差异有高度显著性 (P <0 .0 1) ;化疗后癌组织中LRP的阳性表达率与初治POEC中的表达率差异有显著性 (P <0 .0 5 )。POEC组织中LRP的表达与患者年龄、组织学类型、细胞分级、临床分期和术后肿瘤残存灶大小无关 (P >0 .0 5 ) ;POEC患者LRP阳性表达组近期化疗疗效明显低于阴性表达组 (P <0 .0 5 ) ;但POEC患者LRP表达与患者术后生存时间无关 (P >0 .0 5 )。结论 :LRP在POEC组织中有较恒定的表达 ,化疗可增加POEC组织LRP表达 ,检测LRP可预测化疗近期疗效 ,指导临床化疗方案的选择。

The expression of lung resistance protein in primary epithelial ovarian cancer a nd its clinical significance.

Objective:To investigate the expression of lung resistance protein (LRP) in primary ovarian epithelial cancer (POEC) tissues and its clinical significance.Methods:The expressions of LRP in paraffin embedded 64 cases of POEC,23 cases of cancer obtained in second look laparotomy and 21 benign ovarian tumor were determined by SP immunohistochemical staining and the results were studied in correlation with some clinical and pathological data.Results: In benign ovarian tumor,POEC and cancer obtained in second look laparotomy,the positive rates of LRP expression were 33.3%,82.8% and 100% respectively.The rate of LRP expression in POEC was higher than that in benign tumor (P<0.01).The rate of LRP expression in cancer obtained in second look laparotomy was higher than that in POEC (P<0.05).Statistical analysis revealed that the expression of LRP was not related to patient's age,histologic subtypes,cell differention,FIGO stage,and residual tumors after cytoreductive surgery (P>0.05).Patients with LRP positive expression had poorer response to chemotherapy (P<0.05).Multivariate analysis of LRP expression,histologic subtypes,FIGO stage,tumor grade,response to chemotherapy and residual tumor after cytoreducitve surgery showed that residual tumor (P<0.05) and response to chemotherapy (P<0.05) were related to overall survival. Conclusions:In POEC,the expression of LRP is more frequently observed and can be induced and promoted by platinum based combination chemotherapy.LRP may be helpful in predicting response to chemotherapy and therefore guide therapeutic choices.